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Substance Use Disorders Among Military Veterans

Contributed by Rosemary Williams, Silvermist Recovery

Substance abuse is a significant problem among U.S. military veterans. According to a study published in the journal Substance Abuse and Rehabilitation, veterans are more likely to use alcohol and report heavy alcohol use than their non-veteran counterparts.¹

The National Institute on Drug Abuse notes that alcohol abuse is the most widespread problem among soldiers and veterans. Additionally, prescription drug misuse is on the rise among veterans, with opioids being prescribed at increasing rates for chronic pain.

A number of services and interventions are available through the military to help veterans recover from a substance use disorder. These include VA Medical Centers around the nation, although veterans must be connected to a center to receive help. Many private rehab facilities offer specialized services aimed at veterans and address a range of issues faced by members of the military today.

The stigma of addiction impacts our service members, with active service military members and veterans being reluctant to admit to a substance abuse problem. Fear of what others will think and denial that there’s a problem are other common reasons why veterans may decline to get help for an addiction.

The Scary Statistics of Drug Abuse and PTSD among our Veterans

75% of veterans who have experienced trauma from violence or abuse report problems with drinking and alcoholism.

33% of those who have lived through disasters, traumatic accidents, or serious illnesses report problems with drinking and alcohol abuse.

Alcoholism is more common among those who have chronic pain or continuing serious health problems due to traumatic experiences in their past or PTSD.

500,000 veterans with PTSD received treatment from the VA in 2011

27% of veterans who have received care from the VA for PTSD have a substance abuse disorder.

35% of veterans with an SUD (substance use disorder) also suffer from co-occurring post-traumatic stress disorder.

20% of Veterans from our wars in the middle east suffer from PTSD.

Between 60% and 80% of Vietnam veterans have a problem with alcohol use.

Veterans age 65 or older who have PTSD are at an elevated risk for suicide if they also suffer from depression or have a problem with alcohol.

Soldiers, Addiction, and the Struggle for Help

TRANSCRIPT
Every year 20,000 soldiers are go to the Army’s substance abuse clinics they go there either because they’re sent by their commanders because they’ve had some kind of alcohol or drug-related problem or they go there because they simply need help at the clinics they get screened and assess to find out whether they have any kind of drug or alcohol related problems. Psychologist wanted to cure who just retired as the director of clinical services for the army program talks about what that program has to accomplish the mission of the clinical ASEP is to support army readiness through providing clinical services to the soldiers who are impaired with substance abuse issues after 14 years of war America’s soldiers can be suffering from any number of issues they can have post-traumatic stress disorder traumatic brain injury be having chronic pain with wounds or injuries and they may even have thoughts of suicide a nexus for these problems can be the abuse of alcohol or pain medication in terms of trends we see particular drugs becoming popular in some locations but the most abused drug is alcohol still and it’s been that way practically forever in the Army in 2010 the Army shifted his program for treatment of soldiers from the Surgeon General’s Office to the installation management command the people who run Garrison’s what followed after that was that they lost a lot of talented counselors and clinical directors and the quality of care suffered one result one a cure says if many of the soldiers should get help we’re missed last year over 7,000 soldiers were screamed and not enrolled that is considerably larger than the number of soldiers in the Brigade Combat Team so it’s it really is an issue of concern the consequences of leaving a soldier to languish and alcohol abuse or drug abuse can be tragic some of the soldiers that were screened and not enrolled have gone on to commit acts of violence and sometimes have killed themselves after that as well so while we can’t say that we could have saved folks we can say that we need to do a better job of treating them here explain as it is possible to fix this problem but it takes a collaborative effort it takes integrated services to help soldiers that can have a group of problems all happening at one time a lot of collaboration is required in treating substance abuse because many times there are numerous health factors that have to be addressed and the soldier has to be treated as a whole person and not just treating one part at one place I’m not even talking to other providers the mourn this story visit usatoday.com you

Veterans, Trauma and Addiction

Combat veterans have a high incidence of post-traumatic stress disorder, or PTSD. Each year, around 12 percent of veterans who served in the Gulf War, 20 percent who served in Iraq, and 30 percent who served in Vietnam develop PTSD, according to the U.S. Department of Veterans Affairs.²

Additionally, 23 percent of female veterans reporting being the victim of a sexual assault while serving in the military. In general, half of women who are sexually assaulted will develop PTSD, which is a major risk factor for substance abuse and addiction. All told, up to 75 percent of veterans who have endured trauma from sexual assault or combat report problematic drinking problems.

In 2008, 22% of U.S. Officers in Afghanistan and Iraq suffered from PTSD or depression and only around half of them were treated. As a result, healthcare costs were $ 923 million. If everyone received quality treatment immediately, that cost would have been reduced to $ 785 million.

The link between trauma and addiction is well-established. A study in the journal Addictive Behaviors points out that about half of people in recovery from an addiction have a history of PTSD.³ One in six veterans have symptoms of post-traumatic stress disorder (PTSD) to the point it negatively impacts their daily lives. It’s common for people with PTSD to self-medicate symptoms with drugs or alcohol. Symptoms of PTSD may occur immediately after a trauma, or they may set in months or even years later.

Symptoms of PTSD include:

Nightmares
Fear and anxiety
Insomnia
Depression

Flashbacks
Intrusive thoughts
An inability to concentrate
Withdrawal from family and friends

Risk Factors that can lead to Veteran Addiction

There are certain risk factors identified that can indicate if a veteran is more like to struggle with a substance use disorder(SUD) in the future. PTSD is the most common risk factor, however other risk factors include:

Insomnia
Traumatic brain injuries
Relationship or problems at home
Isolation

While in the military, you work with a team during battle. During treatment, medical professionals become the team supports to address the mental health concern or substance use disorder.

Trauma-Informed Treatment

For veterans who have experienced trauma or have symptoms of PTSD, a trauma-informed treatment programoffers the best chances for successful recovery, according to the Substance Abuse and Mental Health Services Administration.⁴ A trauma-informed approach to treatment seeks to increase a sense of safety.

The trauma informed approach recognizes that:

The impact of trauma is widespread and affects all areas of an individual’s life
There are many pathways to recovery, and a holistic approach is best
The current body of knowledge about trauma must be incorporated into policies, practices and procedures
Actively preventing re-traumatization is an important focus in treatment

Truama informed treatment draws on research-based, trauma-focused therapies that help individuals:

Accept their experiences rather than avoid them
Improve the way they interact with their thoughts and emotions
Develop tolerance for distress
Reduce suicidal thoughts
Achieve feelings of completeness and freedom
Develop control over thoughts, emotions and behaviors

Trauma-focused therapies include acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), eye movement desensitization and reprocessing (EMDR), and mindfulness-based meditation.

Medications Used in Treatment

In some cases, veterans may be prescribed medications to assist with the detox process or to help maintain sobriety. Medications frequently used during the detox process include:

Benzodiazepines
Suboxone
Methadone
Naltrexone
Klonopin

Medications used to help maintain sobriety after detox include:

Buprenorphine
Naltrexone
Methadone
Disulfiram
Acamprosate

When Is It Time to Get Help?

Substance Use Disorder Categories

MILD: by meeting two to three of the following criteria

MODERATE: by meeting four or five criteria

SEVERE: by meeting six or more of the criteria.

Using the substance in ways that puts you or others in dangerous situations
Experiencing relationship problems related to the substance abuse
Neglecting responsibilities at home, work or school because of your substance abuse
Experiencing withdrawal symptoms when you stop using suddenly
Needing increasingly larger doses to get the same effect
Abusing drugs or alcohol for a longer period of time or in larger amounts than you intended
Wanting or trying to cut down or quit but finding you can’t
Spending a lot of time using or recovering from using drugs or alcohol
Experiencing physical or mental health problems as a result of your substance abuse
Losing interest in activities you once enjoyed
Experiencing cravings for the substance

Once alcohol or drug use becomes compulsive despite the problems it causes, professional help is recommended to end the addiction for the long-term. People who meet two or more of the following criteria are diagnosed with a substance use disorder, which may include heavy substance abuse, addiction, and/or dependence. A substance use disorder is characterized as mild by meeting two to three of the following criteria, moderate by meeting four or five criteria, or severe by meeting six or more of the criteria.

What to Expect from Treatment

Getting help for an addiction can dramaticallyimprove your quality of life and sense of well-being. It may also save your life. According to the U.S. Department of Veterans Affairs, more than 6,000 veterans die by suicide each year.⁵ In 2016, the suicide rate for veterans was 26.1 per 100,000 individuals, compared with a rate of 17.4 per 100,000 among non-veterans.

Drug and alcohol abuse can increase the risk of suicide, and it can lead to a range of serious physical and mental health problems. Getting help reduces these risks and leads to a happier, more fulfilling life. A new military study shows that non-medical counseling offered through military resources resulted in improvement for more than three months after counseling ended.

Counseling is frequently offered through military organizations, however, you have the freedom to accept treatment at a civilian facility.¹² For active service members, it is possible for your commander to find out about your treatment through insurance claims or referral requests. Commander involvement may be encouraged as the support of others during recovery can contribute to your success.

Rehab works for most people who choose a high-quality program and participate fully in their treatment plan.

Recovery starts with detox, which is followed by addiction treatment. When treatment is complete, an individualized aftercare plan helps you navigate the early weeks and months of solo recovery.

The Treatments that are Available to Help

How to Find Help

Veterans and active-duty servicemen and women from all branches of the military can find help for a substance use disorder through the U.S. Department of Veterans Affairs mental health services.⁶

Active-duty Army personnel can contact the Army Substance Abuse Program (ASAP) for information and treatment resources.⁷

Active-duty Navy can find support, education and treatment resources through the Navy Alcohol Abuse Prevention (NAAP) program.⁸

The Marine Corps Community Services (MCCS) program offers a substance abuse program for active-duty Marines.⁹

For active-duty Air Force personnel, the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program provides information and treatment resources for those needing help ending an addiction for good.¹⁰

Another healing resource for military personnel is a Strong Bonds retreat, which helps to increase resilience, reduce stressors and tighten family bonds. While Strong Bonds retreats don’t address or treat substance use disorders, they can reduce some of the factors that contribute to substance abuse and addiction.¹¹ Retreats are available for singles, couples, and families.

Housing And Other Help

There are resources available to help veterans secure housing, employment, healthcare and other needs. An individualized treatment plan developed with a case manager should identify and connect you to helpful resources to resolve concerns beyond mental health or a substance use disorder. Some resources include:

HUD-VASH is a Housing and Urban Development (HUD) program that connects veterans experiencing homelessness with housing resources to resolve the housing emergency via rent assistance. The program uses the Housing Choice Voucher Program to assist with the cost of re-housing veterans into rental units.

SSVF helps veterans secure permanent housing solutions with supportive assistance and case management.

Vocational Rehabilitation and Employment (VR&E) services help with job training, employment, resume development, and job seeking skills coaching. There is also assistance avilable for veterans looking to start a business or independent living services for those unable to work.

Speak with a case manager about your individual needs to create a plan that will work for you.

VA and Vet Center facilities can be found online at www.va.gov and www.vetcenter.va.gov

Hope is the Foundation of Recovery

There are many pathways to recovery, but at its very foundation is hope, according to the Substance Abuse and Mental Health Services Administration. Whether you’re a veteran struggling with a substance use disorder or a loved one trying to help your hero, holding on to hope for a better future guides your pathway forward. A high-quality, holistic treatment program is one pathway that’s research-based and proven to help people end a substance use disorder once and for all. Treatment really does work, and it can work for you.

This publication is provided by Silvermist Recovery.

Resources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587184/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2720425/
https://www.samhsa.gov/nctic/trauma-interventions
https://www.mentalhealth.va.gov/docs/data-sheets/OMHSP_National_Suicide_Data_Report_2005-2016_508.pdf
https://www.ptsd.va.gov/public/ptsd-overview/basics/how-common-is-ptsd.asp
https://www.mentalhealth.va.gov/res-vatreatmentprograms.asp
https://home.army.mil/wood/index.php/my-fort/asap-services
https://www.public.navy.mil/bupers-npc/support/21st_Century_Sailor/NAAP/Pages/default.aspx
https://www.usmc-mccs.org/services/support/substance-abuse/
https://www.airforcemedicine.af.mil/Resources/Health-Promotion/Drug-Abuse/
https://strongbonds.jointservicessupport.org/
https://www.militaryonesource.mil/health-wellness/mental-health/substance-abuse-and-addiction/military-policy-and-treatment-for-substance-use